Geriatric status features of type 2 diabetes patients over 65: subanalysis of the EVKALIPT study.

BACKGROUND

Although type 2 diabetes mellitus (T2DM) is common among elderly patients, there are no large studies examining the geriatric status of patients with T2DM.

AIM

To study the characteristics of geriatric status in patients with T2DM aged ≥ 65 years.

MATERIALS AND METHODS

The multicenter EVKALIPT study conducted in 11 constituent entities of the Russian Federation included 4308 patients aged 65-107 years (mean age 78 ± 8 years), who were divided into two groups: with T2DM (n = 935) and without T2DM (n = 3360). All participants underwent a comprehensive geriatric assessment: a survey (step 1) and a physical examination (step 2).

RESULTS

The prevalence of type 2 diabetes was 21.8% (n = 935), predominantly in patients aged 65-74 years. The comprehensive geriatric assessment showed that changes in the geriatric status are more pronounced in T2DM, namely: lower basic activity in everyday life and a lower total score on the Short Physical Performance Battery (SPPB); slower walking speed; lower handgrip strength in women; worse health self-assessment score, higher total score on the geriatric depression scale (GDS-15) and on the questionnaire "Age is not a hindrance;" more pronounced pain syndrome; and the use of a greater number of assistive devices per patient was noted. Geriatric syndromes (GS), which were detected more often in the group with T2DM in comparison without T2DM were: chronic pain syndrome (91 vs 86%, p < 0.001), frailty (67 vs 62%, p = 0.005), basic dependence in everyday life (67 vs 60%, p < 0.001), depression (52 vs 47%, p = 0.004), urinary incontinence (51 vs 44%, p < 0.001), falls (34 vs 30%, p = 0.004%), and pressure ulcers (3.3 vs 2%, p = 0014). Regression analysis demonstrated that T2DM is associated with an increased risk of developing such GS as basic dependence of patients in everyday life, frailty syndrome, pressure ulcers, chronic pain, depression (odds ratio from 1.19-1.78).

CONCLUSION

Geriatric status was worse in patients with T2DM than in those without T2DM. It has been demonstrated that T2DM adversely affects the physical performance of patients aged 65 years and older.

HIGHLIGHTS

To study the characteristics of geriatric status in patients with T2DM aged ≥ 65 years. T2DM was associated with geriatric syndromes due to worse performance status in patients aged ≥ 65 years. In routine clinical practice, it is necessary to identify geriatric syndromes in patients with T2DM. This will foster patient-centered approach, which undoubtedly contributes to improving the quality of life of elderly patients with T2DM.